Individual
LATONYA EVANS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
808 MERRITT DR, GREENSBORO, NC 27407-2237
(336) 763-6027
Mailing address
808 MERRITT DR, GREENSBORO, NC 27407-2237
Taxonomy
Speciality
Code
Description
License number
State
1744P3200X
Prosthetics Case Management
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1744P3200X
CERTIFIED HAIR LOSS SPECIALIST
NC
Enumeration date
09/09/2015
Last updated
09/09/2015
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